Advanced EMTs practically overlooked, except by Border Patrol

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When you call 911 in San Diego County with a medical emergency, you will get a first-responder who is either a paramedic or an emergency medical technician.

On the radio…

What you’re not likely to get is an advanced emergency medical technician, someone with training somewhere between that of a paramedic, who can provide the highest level of emergency services, and that of a regular EMT, who is licensed to provide basic life support. Out of the more than 80,000 emergency medical personnel with an active license in California, only 104 are advanced EMTs.

If given a choice, emergency medical systems prefer paramedics, but hiring them isn’t always possible. Advanced EMTs are mostly “beneficial for those rural areas that have difficulty recruiting and retaining paramedics in their systems,” said Dr. Bruce Haynes, medical director of San Diego County Emergency Medical Services.

Sean Trask is the chief of the EMS Personnel Division at the California Emergency Medical Services Authority. That agency oversees emergency medical personnel in the state, and it licenses paramedics.

He said paramedics in “a really slow, rural area” might leave “to get more experience going into the big city.” Those rural areas might then turn to advanced EMTs as a better option than relying only on EMTs.

For example, an advanced EMT can give a patient naloxone, which can stop an opioid overdose, or epinephrine for an allergic reaction. They can administer medication and treatment for diabetics and people with asthma attacks. Those are all things EMTs can’t do.

Even so, “EMTs have a critical place in our system,” Haynes said. For example, they can provide life saving CPR for a patient with cardiac arrest.

About half of the 104 advanced EMTs in the state are in San Diego and Imperial counties, according to state records.

San Diego County has its rural areas, but its population hardly seems sparse enough to keep it from retaining paramedics. Nevertheless, geography does play a role in the higher local percentage of advanced EMTs — as does the U.S. Border Patrol.

“Advanced EMT agents, they’re able to provide a person that’s suffering from dehydration with an IV,” said Wendi Lee, a spokeswoman for the Border Patrol’s San Diego sector. That’s “very beneficial because we do encounter a lot of migrants that are left stranded out in the mountain areas or the desert.”

Lee said 14 Border Patrol agents have advanced EMT certification in the region. They are part of the Border Patrol Search, Trauma and Rescue Unit.

“We get a lot of hikers out there in the mountain areas in San Diego sector,” Lee said. “Or even our own Border Patrol agents.”

Those agents have been busy. Since October, they’ve rescued 20 people in San Diego County. Last fiscal year they rescued more than 100, Lee said.

Outside of U.S. Customs and Border Protection, advanced EMTs remain a rare breed.

“It’s never really, I think, been used to its full potential,” Haynes said.

Still, the role of advanced EMTs might be expanded, which would make them more attractive in California. Haynes said there’s a debate in the state about whether they should be allowed to administer morphine or other similar pain medications, “which we use with the paramedics for patients with fractures or other injuries.”